The rigidity and relatively primitive modes of operation of catheters equipped with sensing or actuation elements impede their conformal contact with soft-tissue surfaces, limit the scope of their uses, lengthen surgical times and increase the need for advanced surgical skills. Here, we report materials, device designs and fabrication approaches for integrating advanced electronic functionality with catheters for minimally invasive forms of cardiac surgery. By using multiphysics modelling, plastic heart models and Langendorff animal and human hearts, we show that soft electronic arrays in multilayer configurations on endocardial balloon catheters can establish conformal contact with curved tissue surfaces, support high-density spatiotemporal mapping of temperature, pressure and electrophysiological parameters and allow for programmable electrical stimulation, radiofrequency ablation and irreversible electroporation. Integrating multimodal and multiplexing capabilities into minimally invasive surgical instruments may improve surgical performance and patient outcomes.
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The custom MATLAB software for data analysis can be downloaded from https://github.com/optocardiography.
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I.R.E. and J.A.R. acknowledge support from the Leducq Foundation project RHYTHM and R01-HL141470. This project was supported by the National Institute of General Medical Sciences of the National Institutes of Health under grant nos. P41 GM103545 and R24 GM136986, and the Nora Eccles Harrison Cardiovascular Research and Training Institute (CVRTI). K.A. acknowledges support from the National Institutes of Health K99-HL148523-01A1. X.C. acknowledges support from National Key R&D Program of China (grant 2018YFA0108100) and China Scholarship Council. This work made use of the NUFAB facility of Northwestern University’s NUANCE Center, which has received support from the Soft and Hybrid Nanotechnology Experimental (SHyNE) Resource (NSF ECCS-1542205); the MRSEC program (NSF DMR-1720139) at the Materials Research Center; the International Institute for Nanotechnology (IIN); the Keck Foundation; and the State of Illinois, through the IIN.
The authors declare no competing interests.
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Supplementary notes, figures, tables and video captions.
Temperature mapping using the multiplexing circuit with proper grounding.
Pressure mapping on a porcine heart.
Electrogram mapping on a rabbit heart.
Temperature mapping during radiofrequency ablation.
Electrogram mapping on a human heart.
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Han, M., Chen, L., Aras, K. et al. Catheter-integrated soft multilayer electronic arrays for multiplexed sensing and actuation during cardiac surgery. Nat Biomed Eng 4, 997–1009 (2020). https://doi.org/10.1038/s41551-020-00604-w
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